<div class="user-box">
    <form action="" class="form-user">
    	<div class="form-group">
    	  <label>姓名</label>
    	  <input type="email" class="form-control" placeholder="用户名">
    	</div>
    	<div class="form-group">
    	  <label>称谓</label>
    	  <select name="" id="" class="form-control">
    	  	<option value="0">先生</option>
    	  	<option value="1">女士</option>
    	  	<option value="2">小姐</option>
    	  </select>
    	</div>
    	<div class="form-group">
    		<label>验证码</label>
    		<div class="row">
    			<div class="col-sm-4"><input type="text" class="form-control"></div>
    			<div class="col-sm-4"><img src="images/code.png" alt=""></div>
    			<div class="col-sm-4"><a href="#">看不清，换一张</a></div>
    		</div>
    	</div>
    	<div class="form-group">
    	  <label>手机<strong>*</strong><span>(非常重要，如遇问题便于我们与您联络.)</span></label>
    	  <input type="email" class="form-control" placeholder="用户名">
    	  <button class="btn btn-default">获取验证码</button>
    	</div>
    	<div class="form-group">
    	  <label >用户密码</label>
    	  <input type="password" class="form-control" placeholder="密码" >
    	</div>
    	<div class="form-group">
    	  <label >确认密码</label>
    	  <input type="password" class="form-control" placeholder="密码" >
    	</div>
    	<div class="btn-row text-right">
    		<button class="btn btn-primary btn-block">注册</button>
    	</div>
    </form>
</div>

